[Two rare lens abnormalities in horses]. / Zwei seltene Linsenanomalien beim Pferd.

Coloboma and ectopia of the crystalline lens are rarely encountered or diagnosed congenital defects of the equine eye. The clinical and ophthalmoscopic features of a congenital coloboma of the lens in a 3 year old Hanoverian stallion and of an ectopic lens in a 6-month old Hanoverian filly are described and depicted. In the stallion, the lens coloboma was associated with a partial coloboma of the zonules, and in the filly, the ectopic lens was small and spherical (microphakia, spherophakia) and associated with syneresis of and small floaters in the vitreous. Although it cannot be excluded that the ectopic position of the lens may have originated from prenatal uveitis, it was classified as congenital in this case. In both eyes, there were no other clinically detectable congenital defects.

[The surgical therapy of equine recurrent uveitis]. / Zur operativen Therapie der equinen rezidivierenden Uveitis (ERU).

Equine recurrent uveitis (ERU) is the most frequently encountered cause of eye problems and blindness in horses. Classic treatment of ERU includes mydriatics, corticosteroids and nonsteroidal anti-inflammatory drugs. Despite vigorous topical and systemic treatment, however, in many cases, the prognosis for preserving vision remains poor. Experiences with surgical treatment of chronic endogenous uveitis in human patients have shown that vision-impairing axial opacities in the vitreous body can be removed by pars plana vitrectomy, and that a considerable decrease in the frequency and severity of uveitic relapses results. So far, 11 eyes of 10 horses were subjected to vitrectomy. All horses had suffered from 3 or more uveitic attacks and had a hazy vitreous. In all cases, at discharge from the clinic, the vitreous chamber was less hazy compared to preoperative findings. At follow-up examinations, 8 eyes (8/10) had normal i.o. pressure, and 2 (2/10) had subnormal i.o. pressure and the vitreous chambers were clear or contained only small floaters. Uveitic attacks had not been observed in the operated eyes. Postoperative complications included fibrinous, or fibrinous-haemorrhagic exudate in the anterior chamber of all eyes, and in one eye, a minor haemorrhage in the vitreous chamber. Our preliminary results indicate that pars plana vitrectomy assuring proper case selection and accurate surgical technique, may contribute to improvement of vision and may delay the progression of uveitic complications in horses.

[Local anesthetic level and cardiovascular changes following local anesthesia in cataract operations with 3% mepivacaine]. / Lokalanästhetikaspiegel und Kreislaufveränderungen nach Lokalanästhesie für Kataraktoperationen mit Mepivacain 3%.

Are there toxic plasma levels of mepivacaine after local anesthesia for ophthalmic surgery with 3% mepivacaine? What hemodynamic changes occur during injection of the local anesthetics? Fifteen patients undergoing cataract surgery were given 10 ml of mepivacaine (3%) as a local anesthetic regardless of body weight. After inserting an arterial line, blood samples were taken before the beginning of the injection of mepivacaine and after 3, 5, 10, 15, 30, and 60 min. Concentrations of the drug were measured by gas chromatography. During the first 15 min arterial blood pressure and ECG were registered continuously on a multichannel recorder. The maximum mepivacaine plasma levels were estimated after 15 min with a range from 0.28 to 6.95 micrograms/ml (means +/- SD: 4.5 +/- 1.47 micrograms/ml). The blood pressure was elevated over the preoperative value, at the beginning of the evaluation period, but there was no change in the blood-pressure level over the whole period. In 4 patients without known cardiac arrhythmias, ventricular or supraventricular extrasystoles occurred. The mepivacaine plasma levels complied with resorption kinetics, which is an indication that there were few intravascular injections and that the injection technique war correct. On the other hand, in some patients the mepivacaine plasma levels exceeded the toxic level. Even in ophthalmic surgery, local anesthetics should be given in relation to the body weight of the patients. The high blood-pressure levels indicated non-optimal preoperative treatment of the hypertonic patients, which was followed by an intraoperative exacerbation of the blood pressure.

[Perioperative anxiety and postoperative pain suppression in intraocular operations using general anesthesia and local anesthesia]. / Perioperatives Angsterleben und postoperatives Schmerzverhalten bei intraokulären Eingriffen in Allgemeinanaesthesie und Lokalanaesthesie.

UNLABELLED: Intraocular surgery is performed under local or general anesthesia. The indications for these procedures are often dependent on local circumstances. On the one hand, the optimal conditions for operations under general anesthesia, on the other, the negligible stress of local anesthesia, especially for the elderly, are emphasized. To clarify this question, perioperative anxiety behavior and postoperative pain were investigated in geriatric patients undergoing ophthalmic surgery. METHODS: Spielberger's state trait anxiety inventory (STAI) was performed in 31 patients operated on in general (age 71.0 +/- 6.6 SEM) and 31 operated on in local anesthesia (age 71.6 +/- 6.0 SEM) the day before and 4 h after operation. 10 patients in each group were also tested immediately before surgery in the operating room. Postoperative pain was estimated by the patient and postoperative sedation by the investigator using a 4-point scale for each over 8 h. RESULTS: The state (STAI 1) and trait (STAI 2) anxiety scores did not change in these geriatric patients. There were no significant differences between the groups. Postoperative pain was significantly (p less than 0.05) higher after 15 and 60 min after general anesthesia. There was no difference in the frequency of analgetic therapy in both groups, but most opioids were given in the first 90 min after general anesthesia. The patients were more frequently sedated (p less than 0.05) in the first 90 min after general anesthesia then after local anesthesia. DISCUSSION: The scores of state and trait anxiety behavior are comparable to a normal geriatric population, even if normal data cannot always be applied to clinical situations.(ABSTRACT TRUNCATED AT 250 WORDS)

[Pars plana vitrectomy in chronic uveitis]. / Pars-plana Vitrektomie bei chronischer Uveitis.

Sixty-eight patients (74 eyes) with chronic endogenous uveitis underwent pars plana vitrectomy. An increase in visual acuity was observed in 70% postoperatively. Visual results basically depended on the extent of previous damage to the macula. A lensectomy-vitrectomy was done in 23 eyes, while 51 eyes underwent merely a pars plana vitrectomy. The frequency and severity of uveitic relapses were diminished in virtually all cases.

[Opercular aplasia (author's transl)]. / Die Aplasie der perisylvischen Region.

The article reports on 11 cases of opercular aplasia in patients aged 5 to 44 years. Aplasia occurred to a greater extent in the frontal operculum than in the temporal operculum, and was always associated with space-requiring arachnoidal cysts. Symphyses and obstruction of the flow of the basal CSF spaces were also seen. In 91% of the cases, the aplasia was localized on the left side, 91% of the patients were males. The patients tend to decompensate after a cerebrocranial trauma, and in many cases surgery reveals a subdural haematoma which fills the aplastic region, due to detachment of the exposed cerebral veins effecting basal drainage. In the remaining cases, surgery was performed because of general signs of cerebral compression, exacerbation of an existing disease associated with attacks, or because of the space-occupying character of the concomitant arachnoidal cysts. In patients with opercular aplasia without space-occupying arachnoidal cysts, surgery is not performed for the time being; instead, regular neurological and CT control is effected.

[Investigation in patients with central serous retinopathy with the MMPI Saarbrücken (author's transl)]. / Untersuchung zur Objektivierung von Persönlichkeitsmerkmalen bei Patienten mit Retinopathia centralis serosa.

Patients with angiographically proven C.S.R. were investigated with the MMPI. They showed significantly higher scores on the hypochondria and hysteria-scale. The idea, that C.S.R. is an ocular psychosomatic disease is supported by the profile pattern, which shows an elevation of the "Neurotic Triad" with the characteristically depressed "Psychosomatic Valley".

[Case report on "congenital cystic eye" (author's transl)]. / Beitrag zur kausalen Genese des "congenital cystic eye".

The "congenital cystic eye" is a rare ocular malformation due to an arrest of normal development with complete or partial failure in the invagination of the primary optic vesicle between the third and fifth week of embryonic life. A coincidence of maternal varicella infection and congenital cystic eye is described and the possibility of a causal relationship is discussed.

[Angiographic diagnosis of hemangiomas in the orbital region (author's transl)]. / Angiographische Diagnostik von Hämangiomen im Orbitabereich

The polymorphus hemangiomas-especially those of the cavernous type in the orbital region, the face, the scalp or the rhinopharynx are not demonstrable neither by arterial nor venous angiography. If direct puncture of the angioma is possible, the injection of radioopaque medium shows a characteristic picture. The smooth limitation, partial septation and the delayed outflow of contrast medium are important criterions for the differential diagnosis. Moreover the delimitation of the hemangioma from the surrounding tissue is possible and the best surgical access can be selected. If the expanding process is situated in the orbit, and has reached a certain size, the venography of the orbit indicates the extent and localization of the orbital mass.